This twice revised proposal, in response to PA-04-034, Exploratory Grants for Behavioral Research in Cancer Control, focuses on spousal caregivers (CGs) of hematopoietic stem cell transplant survivors - persons known to report elevated levels of distress as compared to both norms and their patient counterparts. Specific Aims are to: (1) Determine, via experimental manipulation, whether or not CGs of hematopoietic stem cell transplant patients engage in protective buffering, a coping mechanism whereby partners shield patients from illness-related concerns or worries, (2) Examine synchrony or lack thereof, desynchrony, among subjective, expressive and biologic indicators of emotion among spousal CGs, and (3) Test the feasibility and implementation of an emotional expression (EE) exercise designed to enhance psychological and immune functioning among spousal CGs. One-hundred and seventeen patient/ spouse dyads will be recruited for the study. Patients and CGs will complete baseline assessments (questionnaires) 4-6 days after the patient's discharge from the hospital; CGs will provide blood samples to analyze TNF- alpha and IL-6. CGs will then be randomly assigned to one of three conditions: EE with the patient present, EE with the patient absent, or a control condition. For the latter, CGs will talk about positive experiences and time management. For all sessions, CGs will talk for 10 minutes on 3 consecutive days, with verbal and nonverbal expressions recorded and concurrent galvanic skin response collected. Follow-up assessments will occur immediately following the third EE session (questionnaires) and again in two months (questionnaires and CG blood draw). This R21 serves as a feasibility/ social laboratory test of methods and measures, intervening with CGs at their greatest time of need. There exists a lack of resources for these CGs. Findings will determine whether CGs benefit from an opportunity to express their emotions, alone and/or in the presence of their patient. If, as hypothesized, CGs benefit from the opportunity to express in the absence of their patient, future research can test methods for such opportunities: written, verbal, face-to-face or internet. If CGs benefit from the opportunity to express in the presence of their patient, dyadic interventions may be warranted. In short, findings from this study can serve as a springboard for future research investigations and, ultimately, clinical interventions. [unreadable] [unreadable] [unreadable]